Tip of the week: Ensure accurate coding of injections
APCs Insider, May 30, 2008
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Report code 90772 (therapeutic, prophylactic or diagnostic injection; subcutaneous of intramuscular) for singly prepared injections. The rule for the same and different drugs does not apply to code 90772.
Due to medically unlikely edits (MUE), providers have experienced submission problems with code 90772 when they report seven units on the same date of service. However, the NCCI made a correction available as of April 1.
Meanwhile, communicate this issue with your revenue cycle committee and speak with your fiscal intermediary. Monitor outpatient claims to ensure that you are being properly reimbursed for the units of service you report. If you have experienced any denials since January 1, note that a letter from NCCI states that it has corrected a few of the MUEs that were causing issues with line item denials and that providers may resubmit the claims after April 1 retroactively to January 1. The letter states the following:
To assist in answering your inquiry, the following information specific to the codes to which you refer is provided:
90761, 90766, and 90772—The MUEs for CPT codes 90761, 90766, and 90772 billed to the Fiscal Intermediaries will be increased on April 1, 2008, retroactive to the original effective date of January 1, 2008. A provider may choose to resubmit the claim lines, which have been “returned to the provider” for these codes after April 1, 2008. The values for the revised MUEs for these codes cannot be provided. MUEs are confidential and are only for the use of CMS and CMS contractors. CMS has not authorized the release of MUEs to the general public or other organizations.
In January, CPT issued code 90776 (therapeutic, prophylactic, or diagnostic injection; each additional sequential IV push of the same substance/drug provided in a facility). Parenthetical notes state that you should not report 90776 for a push performed within 30 minutes of an already reported push of the same substance or drug.
We encourage you to speak with your facility’s pharmacy and your department to determine how pushes are prepared for your facility and develop a policy and procedure to that effect. Unfortunately, medical record documentation by the clinicians does not easily allow a coder to determine whether the IV pushes were individually prepared or administered in portions.
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Comments
0 comments on “Tip of the week: Ensure accurate coding of injections ”
Related Products
Most Popular
- Articles
-
- CMS seeks comment on quality measures
- Practice the six rights of medication administration
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Nursing responsibilities for managing pain
- The consequences of an incomplete medical record
- Q&A: Primary, principal, and secondary diagnoses
- ICD-10-CM coma, stroke codes require more specific documentation
- Neurological checks for head injuries
- OB services: Coding inside and outside of the package
- E-mailed
- Searched